Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population.Methods. Data relative to the hospital course of 2,012 adult patients (age >18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection.Results. Mean age at surgery was 34.4 ؎ 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations (464 patients,

Patients with SS have a high overall survival. Survival probability was lower in patients with associated CHDs and in patients with pulmonary hypertension. Surgical treatment of SS is beneficial in reducing symptoms, however, given the significant risk of post-operative scimitar drainage stenosis/occlusion, it should be tailored to a comprehensive haemodynamic evaluation and to the patient's age.

In Sweden, which has a population of 8.9 million people, pediatric heart surgery was previously performed in four cities. After a long, difficult process, centralization of pediatric heart surgery to two centers was achieved in 1993. The overall 30-day mortality for open-heart surgery on infants and children of 9.5% before the centralization (1988-1991) was reduced to 1.9% in 1995-1997. A causal relationship between the mortality rates before and after the centralization is impossible to prove. Heart surgery was concentrated to the two centers with the lowest surgical mortality, and the reduction in surgical mortality was observed over a short period of time which makes it likely that the centralization of the surgical activity promoted the improved results. During the later time period the amount of more complex surgery was clearly increased compared to that performed previously.

on behalf of the British Congenital Cardiac AssociationBackground-Late mortality after repair of total anomalous pulmonary venous connection is frequently associated with pulmonary venous obstruction (PVO). We aimed to describe the morphological spectrum of total anomalous pulmonary venous connection and identify risk factors for death and postoperative PVO. Methods and Results-We conducted a retrospective, international, collaborative, population-based study involving all 19 pediatric cardiac centers in the United Kingdom, Ireland, and Sweden. All infants with total anomalous pulmonary venous connection born between 1998 and 2004 were identified. Cases with functionally univentricular circulations or atrial isomerism were excluded. All available data and imaging were reviewed. Of 422 live-born cases, 205 (48.6%) had supracardiac, 110 (26.1%) had infracardiac, 67 (15.9%) had cardiac, and 37 (8.8%) had mixed connections. There were 2 cases (0.5%) of common pulmonary vein atresia. Some patients had extremely hypoplastic veins or, rarely, discrete stenosis of the individual veins. Sixty (14.2%) had associated cardiac anomalies. Sixteen died before intervention. Three-year survival for surgically treated patients was 85.2% (95% confidence interval 81.3% to 88.4%). Risk factors for death in multivariable analysis comprised earlier age at surgery, hypoplastic/stenotic pulmonary veins, associated complex cardiac lesions, postoperative pulmonary hypertension, and postoperative PVO. Sixty (14.8%) of the 406 patients undergoing total anomalous pulmonary venous connection repair had postoperative PVO that required reintervention. Three-year survival after initial surgery for patients with postoperative PVO was 58.7% (95% confidence interval 46.2% to 69.2%). Risk factors for postoperative PVO comprised preoperative hypoplastic/stenotic pulmonary veins and absence of a common confluence. Key Words: follow-up studies Ⅲ pulmonary veins Ⅲ pulmonary vein stenosis Ⅲ heart defects, congenital T otal anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease in which all pulmonary veins connect to the systemic veins, right atrium, or coronary sinus. TAPVC can occur in conjunction with a wide variety of cardiac malformations, especially atrial isomerism. Before the advent of cardiac surgery, almost all of these children died in the first few months of life. With treatment, there has been continued improvement in the mortality and morbidity of isolated TAPVC. [1][2][3][4] This can be attributed to progress in surgical expertise and to developments in intensive care such as use of nitric oxide and extracorporeal membrane oxygenation, which have led to salvage of the sickest neonates. Conclusions-Preoperative Clinical Perspective on p 2726Nevertheless, there is an ongoing late mortality in patients with TAPVC. It is frequently associated with postoperative pulmonary venous obstruction (PVO), with an incidence of 5% to 18%. [1][2][3][5][6][7][8][9] Postoperative PVO may be a consequence of an inadequate ana...